Relationships among sense of coherence, oral health status, nutritional status and care need level of older adults according to path analysis.

AIM: Sense of coherence (SOC) is a measurement of ability of an individual to cope with psychological stress and remain in good health. The aim of the present study was to examine the relationships among SOC score, oral health status, nutritional status and care need level of older adults using path analysis. METHODS: We enrolled 53 older adults (17 men and 36 women) who were attending a day care service (mean age 80.4 ± 6.5 years). SOC was assessed using a 13-item, seven-scale instrument. Oral health status (number of present teeth, denture use) and nutritional status (assessed with Mini-Nutritional Assessment Short-Form) were also evaluated. Path analysis was used to examine the relationship of SOC with other related factors, including care need level. RESULTS: The mean SOC score was 57.0 ± 13.9. Mini-Nutritional Assessment Short-Form results showed that one participant (1.8%) was malnourished, 26 (49.1%) were at risk of malnutrition and 26 (49.1%) had normal nutritional status. Participants with high SOC scores showed a strong positive attitude, had a relatively large number of teeth, were in good nutritional condition and showed low care need levels. CONCLUSIONS: The present results showed that maintaining a high SOC level and good oral health help to reduce care need levels in older adults, and also prevent a worsening of their nutritional condition. Geriatr Gerontol Int 2017; 17: 2083-2088.

Clinical trial of glutamate for the improvement of nutrition and health in the elderly.

Dietary free-glutamate (Glu) improves taste and palatability. In our previous study, we found that Glu intake by hospitalized elderly was low and supplementation of monosodium L-glutamate (MSG) to their staple diet improved their behavior. To confirm such findings, we conducted a double-blind and placebo-controlled trial in hospitalized elderly. The study consisted of a 1-month lead-in period, a 3-month intervention period, and a 1-month follow-up period. In the intervention group, 0.5% (w/w) MSG was added to every staple diet, 150 g of rice gruel (the MSG group). Fourteen subjects in the MSG group (average age 83.0 +/- 8.9 years) and 15 in the control group (average age 84.3 +/- 9.6 years) completed the study. The subjects of both groups took most of the given foods based on the energy requirement of each subject's metabolic rate, body weight, and activity. In the last week of each period, nurses assessed the dementia score and daily performance of both groups. The daily performance was improved by dietary MSG. Behavior during mealtime was video-recorded for 5 min in the lead-in period and after 3 months in the intervention period. Significant improvement in the mealtime behavior was observed only in the MSG group. Furthermore, although serum albumin itself did not increase, the ratio of reduced-form albumin to total albumin increased only in the MSG group. In conclusion, supplementation of 0.5% MSG to rice gruel three times a day for 3 months improved behaviors and the nutritional status of hospitalized elderly.

Can dietary supplementation of monosodium glutamate improve the health of the elderly?

Dietary free l-glutamate has been known for a century to improve taste and palatability. Recent evidence suggests that this effect is mediated through specific l-glutamate receptors located on the taste buds. However, l-glutamate receptors are also present elsewhere in the gastrointestinal tract, such as the stomach. Here, l-glutamate exerts physiologic actions beneficial to gut function by stimulating l-glutamate receptors linked to the gastric vagus nerve. In addition, dietary l-glutamate also appears to be an important energy substrate for gut tissue. Can such l-glutamate effects on taste and gut function be clinically useful? Elderly people often develop health problems related to their nutritional status that can be linked to insufficient energy and nutrient intake. A number of studies have examined the potential usefulness of l-glutamate, added to food in the form of monosodium glutamate (MSG), in promoting better nutrition in the elderly and in patients with poor nutrition. Some positive effects have been observed. This article reviews the physiologic roles of dietary l-glutamate in relation to alimentation and examines the evidence linking the utility of MSG supplementation to the improvement of nutrition in elderly and hospitalized patients.

Physiological role of dietary free glutamate in the food digestion.

Gustatory and anticipatory cephalic stimuli during a meal yield nutritional information and aid efficient food digestion. Mammals, including humans, can detect the amount of dietary protein and its quality via cephalic relay to initiate proper digestion in the upper gastrointestinal (GI) tract. In addition to gustatory stimuli, visceral sensing by the abdominal vagus conveys primary afferent nutritional information from the digestive system to the brain. Electrophysiological studies indicated that abdominal vagal afferents, which were innervated into the stomach and intestine sending information to the brain, were activated by luminal glutamate. Histochemical analysis also revealed the existence of a glutamate signalling system (metabotrophic glutamate receptors) in the GI tract. Luminal glutamate in the stomach and intestine provides the efferent reflection of the abdominal vagus, supporting the modulation of exocrine and endocrine excretion during digestion. These results strongly indicate that glutamate has regulatory effects on the food digestive processes through the gut nutrient-sensing system. It plays physiological and nutritional roles and initiates digestion in the stomach as well as anticipates subsequent processes in the small intestine and the liver. We reviewed recent studies on glutamate physiology in the gut including our research, and discussed the physiological significance of dietary free glutamate in the regulation of gut function, focusing on the visceral sensation from the stomach.

A possible application of monosodium glutamate to nutritional care for elderly people.

Recently, it has been clarified that glutamate (Glu) can stimulate the umami taste as well as the visceral sensation to help the gastric protein digestion. Our survey suggests the possibility that the amount of free Glu in hospital foods is lower than that in ordinary foods. In the present study, monosodium glutamate (MSG) was supplemented to meals for 11 elderly inpatients during 2 months, and the fortification effects on their nutritional status, general condition, and quality of life (QOL) were investigated. The degree of recognition was improved, and peripheral lymphocytes were increased, even when there was no change in nutritional intake or protein nutritional status. Based on these results, we concluded that appropriate utilization of Glu for nutritional care of the elderly people would be useful for improving QOL.